Assisted-Feeding and Hepatic Lipidosis

Hello! I know I'm new around these parts. I also know more than a few of y'all have dealt with HL. We just started treatment today on our 7 year old cat, Callie. I'm syringe-feeding her, trying to find the groove with how often and how much.

Some things about Callie:

She will not eat. (duh?) 

She will drink when I set her next to the bowl...but is not proactive.

She will urinate when I set her in her litterbox... otherwise she'll go on the floor.

She's on Cyproheptadine for appetite.

She's on Lactulose for ammonia.

She's got a bowl of food, just in case. 

She's getting Royal Canin Recovery RS (for now... I'm open to other options)

She's in a quiet room, separate from everyone else, because her brother will eat all her food...sometimes brothers do that. 

Some things about me:

I have a spreadsheet with times and doses and whatnots of her treatment.

I have a raging headache.

I'm trying to be hopeful and positive...but I'm remaining cautious and realistic.

I'm so glad to have some safe place to talk about this with knowledgeable people.

Anyway. That's my story and I'm stickin' to it.

Thanks for reading.

If you have any tips or tricks or testimonials or support or anything... I could use it.

Welcome to TCS Jynical!  First off I am really sorry you and your kitty are going through this.  Secondly, I have never experienced this situation so besides emotional support, I can offer no intelligent advice or suggestions.  But I'm sure there are lots of folks here who have and will respond.  There are 399 threads on Hepatic Lipidosis on TCS.  Just type it into the search feature and they will pop up.  Here is an article on it.  It is technical but does offer an excellent overview of it http://www.vet.uga.edu/vpp/clerk/turner/index.php Best of luck to you and I am sending vibes

Callie was completely moody with me this morning. I managed to get a little bit of food into her, but she was put out about it. She used her litter box overnight. One day at a time, I suppose. Or... feeding at a time.

Welcome, and I'm sorry you've been brought here due to Callie's situation.  I've been there, and my Bashful ended up with a feeding tube inserted directly into his stomach.  That was a long time ago, and now they have improved that greatly and many cats end up with a tube inserted in their necks (somehow) which is much easier on them.  Anyway, back to Callie. 

I'm guessing your Vet showed you how to syringe feed her by thinning down the Royal Canin with enough water, etc. and put the syringe in the side of her mouth and go very slowly?  We used to feed Bashful every 4 hours (yep, even in the middle of the night, but obviously he was very bad off since he required a feeding tube)

I don't understand the use of Lactulose for ammonia?  Usually that's for constipation, but she may be having problems in that department too, since usually cats with HL don't drink enough either.

HL is obviously a bad situation, but many, many cats have survived it.  One in particular, Bear, was on his last leg, and if you can find his thread (sorry, I'm already late or I'd search for it for you) it will give you lots of inspiration, I'm sure.

Vibes for your little girl.  Keep us posted, and do ask questions.  We're here to help. 

Thanks for the support! It's greatly appreciated.

About the lactulose - the vet said that while it is a laxative, it binds the ammonia particles so the body doesn't have time to absorb them, and they just get passed out of the body. It works as a support for the taxed liver. 

As an update update from even this morning... Callie is cranky, but she willingly sniffed at the food I have set out for her in a bowl. And while she's upset about the feedings and being restrained, I take that as sign of mental awareness which wasn't there yesterday. And I will take cranky and alive over not cranky and not alive any day of the week.

This killed our first cat, Snoopy, and we had no way of finding out what to do about.  Things have improved a lot in 25 years!

And I know what you mean about cranky.  We knew our cat Truman wasn't long for this world when he stopped fighting us when we medicated him.

I wish you the best of luck dealing with the tough problem.

My cat had undiagnosed IBD which went into this a little over a year ago.  I went the feeding tube way which I thought was easier and less stressful for both him and me. The tube was inserted into his esophagus through the side of his neck.  The vet wrapped a bandage around his neck with a hole in it for the tube and put a stretchy bandage over the gauze bandage also with a hole in it. He tolerated it well but of course there is always a risk with anesthetic especially with a cat that has a compromised liver but he was under for 2 or 3 minutes. I was feeding him Hills A/D which is a high calorie nutrient dense food. I know Royal Canin also has prescription foods so it may well be the same type of food. He was on the feeding tube for about 3 weeks and he has been fine since. The vet keeps a closer eye on him now. He goes to the vet every 6 months rather than annually.

MrBlanche - Thank you for the luck! I definitely am welcoming of any and all good juju. I'm sorry that this illness took Snoopy from you. And yes, I'm a firm believer that that will-to-live is so important a guide to treatment. I was massaging and talking to Callie just a bit ago before our last feeding... and I told her to fight. I told her to be cranky and fight me and to keep going. I want to see that, y'know?

Denice - I'm so glad your kitty is doing better. We have a prescription for Hills A/D too, but the place I was at was out. I'm definitely not ruling out tube feeding if she continues to decline. She goes back to the vet this Friday to see where we're at. Hopefully it's something we can avoid, but... only time (and copious amounts of food and love) will tell.

Vibes for your Callie. Really, for "just" fatty liver, the "cure" is food itself. :nod:

My question is... what caused it? Has what caused the inappetance been identified? Of course, sometimes it's as simple as a URI, and especially an overweight cat not eating for even just 24 hours can start the process. For cats that are the appropriate weight, it should take at least several days. Whatever happened... I hope all she needs right now is food support, and that she'll take off eating like a champ on her own right soon, and that'll be the end of it!

When Lazlo wasn't eating on his own (a cancerous tumor in his stomach), I fed him 30ml at a time, 4x a day. Then I moved it to 45ml, 3x a day. :nod: I used 15ml syringes - made it SO much easier than those little things they give you at the vet! I found the Royal Canin really soupy. I preferred using the Hill's Pet a/d. :nod:

Back in the start of November last year my 7.5 yr old male kitty was diagnosed with HL. It was horrible. He developed it over a long period of time (several months) without me noticing before external signs started popping up. I still feel awful about noticing it before, but that's in the past now...I know better now. Anyways, it got really bad. He was anorexic, jaundiced, constipated, dehydrated, the works. I had to take him to the veterinary hospital and have him stay the weekend. It was really difficult on deciding what to do (whether to put him down because over half his liver was already shot and counts of this and that were extremely low). I could spend the money and try saving him, but the costs were a lot for end results that I didn't know...but in the end I figured he wasn't hurting and he still craved life. I could tell. I too feel that's important. As long there's a will to live, don't give up on them. That's how it was for me. So by then the money didn't matter, Smokey did.  Even though the vets were optimistic about his recovery, the test results in the beginning were very bad. I visited him twice a day to comfort him. I feel that really gave him the push to keep on living. By the time the weekend was over I was allowed to take Smokey home because he was improving already and I told them I was ready.

I feed him first through a nasal tube that went down through his nose and into his gut. I feed him a high fat/ high protein liquid diet every 4hrs with that. He had no interest in food or water but I believe that to be the nose tubes fault as it hung in the way of his face and it also made him extremely nauseous, constantly drooling bile. At least he was using the litter box on his own. I brought him back to the hospital a few days later after little to no improvement due to the annoying nose tube. I paid to have a tube be surgically placed into the side of his neck. Holy cow! Totally worth it. I was worried about them putting him under because he was already weak, but I figured if it's not this then there's no other way to get food into him. Feedings were faster and more comfortable. I could feed him in 15-20 minutes verses 30-1hr from the nose tube. I fed him a warmed slurry of royal canin recovery for the whole time he had that neck tube (about a month). I believe it was 30ml of water blended with one can of recovery. I fed him every 4-6 hours and about 35ml at a time. I gave him water through that tube too, about 25ml of water each time. I think he kind of liked it too, always being full. In about 24hrs I would end up feeding him 200ml of slurry food. The vet tech will show you how to feed your kitty this way too and should give you complete instructions to take home too. It's actually really easy. By the end of it all, I was a pro.

In partnership to proper meds, nutrition and plenty of water is the number one key to getting your HL kitty back to health. You have to be very aggressive about it and never give up. I know. I cried so many times whether it was about him not making it or the vet bills, or still not being interested in food. Yes, that's the other thing, it may take a long time till he starts to eat enough food on his own. It took Smokey over month to be eating the right amount and drinking enough water. I believe it's good to have them eating and drinking the proper amount (whatever your vet says depending on the cat) all on their own for at least a week before you take out the tube.

So....long story short, Smokey recovered....well, he's still kinda recovering. Just needs to put on a little more weight. He's at 8.5-9lbs now, yay!! This is my story with Smokey. His case was super bad, but he pulled through. Luck be with us that he only developed it because of IBD he had way back and then not liking his new food. But HL can often be secondary to something else....I hope you find out whether it's primary or secondary because it will make a world's difference. Sorry this was so long, I just want you to know that even in the worst of times, when all feels in despair, it's not lost. That no longer is a yellow cat necessarily a dead cat. All in all, with constant diligence and faith, your kitty has a chance. Here, this is a great article the animal hospital gave me when we were treating Smokey, it helped me understand a lot better too. http://www.veterinarypartner.com/Content.plx?P=PRINT&A=1455

I'm very sorry your kitty has HL, it's a hard thing to deal with. You kitty sounds like he's still kicking around though and that's good to hear. None the less, I pray for you and send my vibes to where ever you are!

Thank you everyone for your stories and support.

A little update: Callie is very feisty today during feedings. She meows and twists and struggles to run off. We've tried wrapping her up and she still manages to get a paw free to bat our hands away. I brought home a few different types of food... hoping to maybe spark her interest with one.... and sure enough, I opened a bag of kitten food and she stuck her head in and ate a few bites. Granted, we have a long, long road to go...but any effort she makes in feeding herself is a step in the right direction for me. 

She has another vet visit scheduled for Friday. I'm staying home from class tomorrow to take care of her until my partner gets home from work and can take over feeding duty while I go to work. 

I wish I could will her well... y'know?

Recovery from this is a slow process and persistence with feeding them when they don't want to eat is the only way for them to get well.  I know with Patches even after he was eating well on his own it took a while for his bloodwork to start to look better, it's just a slow process.

Oh definitely. We're in for the long haul. She ate from the bag a few more times tonight after our syringe-feeding session. I played some videos for her on YouTube of birds eating and cats purring and meowing to be fed. She laid in my lap watching and purring along. 

Originally Posted by Jynical  

A little update: Callie is very feisty today during feedings. She meows and twists and struggles to run off. We've tried wrapping her up and she still manages to get a paw free to bat our hands away. They make cat bags specifically for this purpose. Here's an example:  

http://www.amazon.com/Feline-Restraint-Bag-10-15-Royal/dp/B001AH0NYK

I brought home a few different types of food... hoping to maybe spark her interest with one.... and sure enough, I opened a bag of kitten food and she stuck her head in and ate a few bites.  Good idea, but remember, you will still need to keep syringe feeding here for quite awhile...just nibbling a few bites here and there will not be nearly enough to do the trick. Granted, we have a long, long road to go...but any effort she makes in feeding herself is a step in the right direction for me. You bet

She has another vet visit scheduled for Friday. I'm staying home from class tomorrow to take care of her until my partner gets home from work and can take over feeding duty while I go to work. 

I wish I could will her well... y'know?  Absolutely...don't we all

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Denice said:

Recovery from this is a slow process and persistence with feeding them when they don't want to eat is the only way for them to get well.  I know with Patches even after he was eating well on his own it took a while for his bloodwork to start to look better, it's just a slow process.

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Yes, and even when she is eating pretty well on her own, you might STILL need to continue assist feeding her for awhile as well.

Jynical said:

Oh definitely. We're in for the long haul. She ate from the bag a few more times tonight after our syringe-feeding session. I played some videos for her on YouTube of birds eating and cats purring and meowing to be fed. She laid in my lap watching and purring along. 

Click to expand...

Awww.  This shows she is still enjoying life.  Good news!

Oh yes, I'm definitely syringe-feeding until I'm told I can stop. lol

She seemed interested in the laser-pointer today, which was cool... she watched it and moved her paw towards it, but stayed laying down...which was fine. Rome wasn't built in a day. She ate more out of the bag and the bowl, and the syringe. Unhappy about the latter... but that's fine. We moved her to another room today so she'll have more interaction. Guinness (the other cat) was checking her out before I put the food down and made him leave. He and Roscoe (the dog) miss her, I think. 

She now has a bed to go under, which will make feeding time infinitely more interesting. But she'll get to cozy up to us at night if she feels like it...and she gets to check out the front of the house in her favorite window. 

One day at a time, one foot in front of the other...but hopefully we're going to stay on the right track.

3 1/2 years ago I lost my sweet girl Alex to Triaditis (fatty liver/HL, pancreatitis, IBD). It was the worst time in my life. She had a feeding tube and was doing great until overnight she developed a pancreatic infection. She died that next day in my car on the way to the ER. Now I'm on a mission to help others with their kitties who have these horrible diseases. I'm sorry Callie has HL. You're doing what needs to be done and that's a big plus for her.

How is your Callie doing, btw?  Hopefully she is coming right along and getting more comfortable being force fed.

Finnlacey, so sorry you lost your Alex. 

Thank you so much, even after all this time it's still very difficult some days. I spent my time now trying to help others with these awful diseases and it pains me each time someone loses a baby like this. I really appreciate it.

Aww Finn *hugs* I'm so sorry.

I wanted to post an update... Callie went back to the vet last Friday (one week after diagnosis) and she had gained a pound and was much less wobbly. She came out of the carrier and was marking the computer screen with her face and loving on the vet. I was told to keep on keepin' on and come back in 2 weeks. This week, Callie has been sleeping on the bed as opposed to under it. She still hates feedings and is stronger and fighting more during feedings. She's using the litter box and drinking and choosing to eat on her own... just need her to choose it more often. It's a long road ahead of us still... but we're pointed in the right direction, I believe.

Jen

Jen, that is just a great report! :heart2: :rub:

Finnlacey, I'm so sorry about Alex.